{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T03:15:23Z","timestamp":1786763723845,"version":"build-2736575974"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"Supplement_2","license":[{"start":{"date-parts":[[2020,7,29]],"date-time":"2020-07-29T00:00:00Z","timestamp":1595980800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1194582"],"award-info":[{"award-number":["OPP1194582"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004423","name":"World Health Organization","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004423","id-type":"DOI","asserted-by":"publisher"}]},{"name":"University of Maryland School of Medicine"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,7,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Typhoid fever has been endemic on the island nation of Samoa (2016 population, 195\u2005979) since the 1960s and has persisted through 2019, despite economic development and improvements in water supply and sanitation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Salmonella enterica serovar Typhi isolates from the 2 hospitals with blood culture capability and matched patient demographic and clinical data from January 2008 through December 2019 were analyzed. Denominators to calculate incidence by island, region, and district came from 2011 and 2016 censuses and from 2017\u20132019 projections from Samoa\u2019s Bureau of Statistics. Data were analyzed to describe typhoid case burden and incidence from 2008 to 2019 by time, place, and person.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In sum, 53\u2013193 blood culture-confirmed typhoid cases occurred annually from 2008 to 2019, without apparent seasonality. Typhoid incidence was low among children age\u2005&amp;lt;\u200548 months (17.6\u201327.8\/105), rose progressively in ages 5\u20139 years (54.0\/105), 10\u201319 years (60.7\u201363.4\/105), and 20\u201334 years (61.0\u201379.3\/105), and then tapered off; 93.6% of cases occurred among Samoans\u2005&amp;lt;\u200550 years of age. Most typhoid cases and the highest incidence occurred in Northwest Upolu, but Apia Urban Area (served by treated water supplies) also exhibited moderate incidence. The proportion of cases from short-cycle versus long-cycle transmission is unknown. Samoan S. Typhi are pansusceptible to traditional first-line antibiotics. Nevertheless, enhanced surveillance in 2019 detected 4 (2.9%) deaths among 140 cases.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Typhoid has been endemic in Samoa in the period 2008\u20132019. Interventions, including mass vaccination with a Vi-conjugate vaccine coadministered with measles vaccine are planned.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciaa314","type":"journal-article","created":{"date-parts":[[2020,3,19]],"date-time":"2020-03-19T20:12:01Z","timestamp":1584648721000},"page":"S120-S126","source":"Crossref","is-referenced-by-count":29,"title":["Tenacious Endemic Typhoid Fever in Samoa"],"prefix":"10.1093","volume":"71","author":[{"given":"Michael J","family":"Sikorski","sequence":"first","affiliation":[{"name":"Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA"},{"name":"Ministry of Health, Government of Samoa, Apia, Samoa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachin N","family":"Desai","sequence":"additional","affiliation":[{"name":"Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA"},{"name":"Ministry of Health, Government of Samoa, Apia, Samoa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siaosi","family":"Tupua","sequence":"additional","affiliation":[{"name":"Ministry of Health, Government of Samoa, Apia, Samoa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert E","family":"Thomsen","sequence":"additional","affiliation":[{"name":"Ministry of Health, Government of Samoa, Apia, Samoa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Han","sequence":"additional","affiliation":[{"name":"Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA"},{"name":"Ministry of Health, Government of Samoa, Apia, Samoa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Savitra","family":"Rambocus","sequence":"additional","affiliation":[{"name":"Ministry of Health, Government of Samoa, Apia, Samoa"},{"name":"Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susana","family":"Nimarota-Brown","sequence":"additional","affiliation":[{"name":"Ministry of Health, Government of Samoa, Apia, Samoa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linatupu","family":"Punimata","sequence":"additional","affiliation":[{"name":"Ministry of Health, Government of Samoa, Apia, Samoa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salesa","family":"Tusitala","sequence":"additional","affiliation":[{"name":"Ministry of Health, Government of Samoa, Apia, Samoa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Sialeipata","sequence":"additional","affiliation":[{"name":"Ministry of Health, Government of Samoa, Apia, Samoa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seth A","family":"Hoffman","sequence":"additional","affiliation":[{"name":"Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J Kathleen","family":"Tracy","sequence":"additional","affiliation":[{"name":"Clinical Translational Research and Informatics Center, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen E","family":"Higginson","sequence":"additional","affiliation":[{"name":"Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon M","family":"Tennant","sequence":"additional","affiliation":[{"name":"Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jillian S","family":"Gauld","sequence":"additional","affiliation":[{"name":"Institute for Disease Modeling, Bellevue, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J","family":"Klein","sequence":"additional","affiliation":[{"name":"Institute for Disease Modeling, Bellevue, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan A","family":"Ballard","sequence":"additional","affiliation":[{"name":"Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy M","family":"Robins-Browne","sequence":"additional","affiliation":[{"name":"Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordon","family":"Dougan","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Cambridge, Cambridge, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric J","family":"Nilles","sequence":"additional","affiliation":[{"name":"World Health Organization, Division of Pacific Technical Support, Suva, Fiji"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin P","family":"Howden","sequence":"additional","affiliation":[{"name":"Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at 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